A COMPREHENSIVE REVIEW ON THE CONCEPTS OF RUKSHANA

A COMPREHENSIVE REVIEW ON THE CONCEPTS OF RUKSHANA

Bhavya B.S1, Pampanna Gouda H2

1P G Scholar, Department of Samhita, SDM College of Ayurveda, Udupi,

2Associate Professor,Department of Samhita, SDM College of Ayurveda,Udupi, Karnataka,

India.

ABSTRACT

The Roga manifests in two forms either as Sama or Nirama, the treatment protocol

varies depending upon Sama and Nirama Avastha of Roga. Rukshana is one such treatment modality primarily aims at converting the Sama into Nirama Avastha. Technically is Sneha Abhava i.e. devoid of Snigdha Bhava. According to Astanga Hrdhyakara Rukshana is one among the Apatarpana Chikitsa which includes Langhana, Rukshana and Swedana. Rukshana and Langhana always goes hand in hand with a minor demarcation in approach, Ruksha Bhava is predominant in Rukshana whereas Laghu Bhava is predominant in Langhana, the effccts of both these treatment modalities are one and the same i.e. the Samyak, Atiyoga and Ayoga Lakshana.

Key Words: Rukshana, Langhana, Apatarpana

INTRODUCTION

Ayurveda deals with both curative and preventive aspect. In both these grounds Rukshana plays very important role in treamtent. The Chikitsa is of two types mainly Santarpana and Apatarpana1.

 Santarpana comprises of Brimhana, Snehana and Sthambana; whereas Apatarpana comprises of Langhana, Swedana and Rukshana. Santarpana Chikitsa for Apatarpana Rogas and Apatarpana is the Chikitsa for Santarpana Rogas. In present era almost all the diseases are of Santarpana Roga mainly caused due to 1. Sedentary life style 2. Change in eating habits 3. Lack of apropriate physical excersises and 4. Undue mechanical life style. The Santarpana is contributed by the intake of more quantity of sweets, oily foods, lack of exercise, habit of day sleep and who lives with all comforts suffers from Santarpana Janya Rogas, Here Apatarpana becomes the first line of treatment which includes Rukshana 2.

Overweight and obesity are leading risks for global deaths. Around 3.4 billion adults die each year as a result of being overweight or obese. In addition , 44% of the diabetes burden, 23% of the ischaemic heart disease burden and between 7% and 41% of certain cancer burdens are attributable to overweight and obesity. Globally, an estimated 10% of school children, between 5 and 17 years of age, are overweight or obese. India is the third most obese country in the world. In all these cases it’s the Rukshana Chikitsa being ideal.

Review of Literature:

Rukshana

The treatment modality which causes dryness, roughness and non-sliminess is Rukshana3 .

The Gunas of Rukshana are Ruksha,Laghu, Khara, Tikshna, Ushna, Sthira Apicchila and Kathina4. According to Astanga Hrudhyakara the Gunas opposite to Snehana is Rukshana i.e. Laghu, Ushna, Sthira, Ruksha, Tikshna, Sthula, Kathina and Sandra. There are few exceptions i.e. even though Sarsapa Taila, Chaaga Kshira (milk of sheep), Pratuda and Viskira Mamsa are Laghu they act as Snehana.

Matsya(fish) and Mahisa Mamsa(meat of buffalo) is Ushna but acts as Snehana.

Yava and Raja Masha is Guru Sheeta and Sara but are Rukshana5. The Aghraya (best)  Dravya for Rukshana is Uddalakanna according to Acharya Charaka.

The Samyak, Atiyoga and Ayoga of Rukshana are described as similar to that

Of  Langhana. Chakrapani has cited the difference between Langhana  and Rukshana6 as stated in the Table 1

Table 1 Difference between Langhana and Rukshana

Sl. No.	Langhan	Rukshan
1.	Laghu gun is predominent	Rukshan gun is predominent
2.	Dravyabhuta or Adravyabhuta	Mainly Dravyabhuta
3.	Gaurav abhava	Sneh Abhavah
4.	Sara gun	Sthira gun

Samyak Yoga of Rukshana- The signs and symptoms of proper administration of Rukshana Chikitsa7-

·        Proper elimination of Vata, Mutra and Purisha (flatus, urine and faeces)

·        Feeling of lightness of the body

·        Feeling of purity of the chest, belching, throat and mouth

·        Disappearance of drowsiness and exertion

·        Appearance of sweat and taste for food

·        Appearance of hunger and thrist

Ati yoga of Rukshana- The signs and symptoms of excessive administration of Rukshana Chikitsa8-

·        Pain in the joints

·        Body aches

·        Cough, dryness of mouth,

·        Loss of hunger, anorexia and thrist,

·        Weakness of the ears and eyes,

·        Delusion

·        Upward movement of Vata

·        Loss of consciousness

·        Loss of strength of body and Agni

Ayoga Lakshana of Rukshana- The features of inadequate administration of Rukshana Chikitsa9-

·        Non alleviation of Doshas and Dhatus

·        Aggravation of diseases

Maha Bhuta Predominent- Agni, Vayu and Akasha Mahabhuta are predominant of Rukshana10.

Predominent Rasa in Rukshana- The three Rasas which acts as Rukshana are Kashaya, Katu and Tikta Rasas11. The effects of Rasas are as shown in the table 2

Table No. 2 Predominent Rasa of Rukshana

Sl. No.	Rukshan
1.	Kashaya	Rukshatama
2.	Katu	Rukshatra
3.	Tikta	Ruksha

Means of attaining Rukshana

Rukshana is achieved by the intake of Katu, Tikta and Kashaya Rasas, Vyavaya, consumption of Khalli, Pinyaka and Madhu12. Other means are Shodhana, Ruksha Sweda, Ruksha Lepa etc.

Indications of Rukshana

Patients suffering from diseases caused due to the obstruction of Srotas, due to Maha Doshas, affliction of Marma Sthana and diseases like Urusthamba, Vatarakta, Prameha etc13. Acharya Bhela has added few indications as in the case of Ati Snigdha and Kaphaja Rogas14. In all the Kleda dominant disorder Rukshana is the prime Chikitsa.

Importance of Rukshana in Shodhana –

According to Astanga Hrudhyakara in the case of Mamsala, Medhura, Bhuri Shleshmala and Vishama Agni initially Rukshana Karma has to be performed followed by Snehana. Then, such persons will not suffer from diseases caused by excess Snehana. Sneha, administered in such a way doesnot get accumulated in the

body and helps in letting out the Doshas smoothly15.

The Pachana Dravyas given in the Purvakarma acts as Rukshana16. Majority of Pachana Dravyas are predominant with Ruksha Guna thus acts as Rukshana.

Rukshana is also adopted as the treatment for Vyapat i.e. in Snehana Vyapad17.

Shodhana also leads to Rukshana it is stated in the Sneha Adhyaya of Charaka

Samhita 18.

Role of Rukshana in Dinacharya and Rutucharya

The Dinacharya procedures which acts as Rukshana are Vyayama, Udvartana, Tambula Sevana, Dhuma Pana etc. Also in the Nithya Sevana Dravyas Yava, Madhu and Amalaki constitute Rukshana19.

The Samvatsara is being divided into two as Uttarayana and Dakshinayana and they further classified into six Rutus i.e. Uttarayana comprises of Shishira, Vasant

and Greeshma Rutu and Dakshinayana comprises of Varsha, Sharad and Hemanta

Rutu . Shishira, Vasant and Greeshma by their nature are predominant with Ruksha

Bhava thus leads to Bala Kshaya whereas Varsha, Sharad and Hemanta by nature are predominant with Snigdha Bhava. Thus Rukshana is ideal in Dakshinayana which is achieved by Ahara, Vihara having Ruksha Guna. Rukshana are achieved by Yava, Madhu,Madhya, Aristha Vyayama, Vyavaya, Udvartana20 etc.

DISCUSSION

Rukshana is rightly pointed by Acharya Charaka by giving it as one among the Shadvidha Upakrama , play an important role in Ayurvedic Chikitsa. It is the absence of Snigdha Bhava. Rukshana may be an Avasthika Chikitsa which is mandatory in certain conditions or asole treatment in a given disease i.e. Snehana Vyapad wherin Kapha Pitta Dosha attain Utklesha Avastha one has to restore Rukshana in the form of Shodhana, Shamana, Ahara, Vihara etc. Also it is the sole treatment in the case of Urusthamba, Prameha, Vatarakta etc. According to Hemadri “Rukshe Shoshane21” i.e. Ruksha Guna is responsible for Shoshana. Rukshana is contraindicated in the case of Vata Dosha as Ruksha is the predominant Guna of Vata Dosha . Always care should be taken during the Rukshana Chikitsa as there will be Vata Prakopa. In the Grahani Chikitsa Acharya Charaka has stated in a Krusha (emaciated) and in Bahu Shleshma one has to adopt alternate Snigdha and Ruksha Chikitsa to prevent loss of Bala (strength)22. In the case of Ghritha Vyapad, Takra Siddha Yavagu is the treatment and in the case of Taila Vyapad Yavagu prepared with Takra and Pinyaka is the treatment23. From this example it is clear that in the case of Vyapad of Ghritha it is treated with Takra, Takra is one of the form ,from which the Sneha Amsha is been extracted

and similarly when Taila is extracted we get Pinyaka and in the case of Vyapad of

Taila its constituent Pinyaka is used as treatment. Langhana and Rukshana are both

categorized under Apatarpana Chikitsa and their Phala Sruthi (effect of treatment) are one and the same but there is small differenence in practical approach as in a

patient, if Snigdha Bhava is predominant then Rukshana is ideal and results in Ruksha Pradhana effect and if Prithvi Bhava is predominant then Langhana is ideal and results in Laghu Pradhana effect. The three Rasas which acts as Rukshana are Kashaya, Katu and Tikta Rasas. In a condition of disease where requirement of Rukshata is maximum namely in the diseases caused due to Kapha Dosha, Kashaya Rasa is the choice wheras in the diseases caused due to Vata Dosha, Tikta

Rasa is the choice as there will be minimum Vata Prakopa by the usage of Tikta Rasas i.e. when compared with the other two Rasas Tikta Rasa is comparatively less Ruksha. It is rightly said that Rukshana is Sneha Varjitha Kriya but in practice, Sneha is one among the Ahara Parinamakara Bhava24 and also in the Ashana Pravichara i.e. the dietic rules it is said that one should consume Snigdha Ahara25.

In practice Rukshana is implemented in the form of

1. Shamana

2. Bahirparimarjana

3. Ahara

4. Vihara

Shamana – Rukshana Dravya figures out in Lekhana Dasemani and specific Yogas are spoken in the context of Urusthamba like, Aristha and Kshara Prayoga, Samangadi Yoga, Srivestakadi Yoga, Murvadi Yoga, Swarnaksiryadi Yoga etc. Apart from this even Rasa Dravyas like Tamra Bhasma are Ruksha Dravyas. Even Asava and Aristha are potent Ruksha Dravya. Bahir Parimarjana – Udvartana, Ruksha Kanji Seka, Ruksha Lepa etc. Ahara – Kodrava, Uddalaka, Kulattha, Takra, Yava etc. Vihara – Vyayama etc. Ayurveda mainly stresses on Swasthya Rakshanam, in this regard it emphasis on Shad Rasopetha Ahara i.e. Ahara which contains all the six Rasas namely, Madhura, Amla, Lavana, Katu, Tikta and Kashaya which is consisidered as Satmya. Amla, Lavana, Katu, Tikta acts as Deepana and Pachana and Kashaya, Tikta and Katu Rasa acts as Rukshana and Kashaya stands first in the case of Rukshana. Madhura, Amla and Lavana are the Rasas having Snigdha Bhava and Katu, Tikta and Kashaya Rasas have Ruksha Bhava26. If one indulges in the consumption of only Snigdha Bhava Rasas there will be Kledana of Dhathus thereby increase of Dhathus will be attained on contrary to this is Ruksha Bhava Rasas which does the Shoshana thereby the balance of the body is achieved. Shad Rasopeta Ahara is considered as the balanced diet according to Ayurveda which fulfils all the requirements of the body. Hemadri and Adhmalla have opined Pachana as Rukshana. According to Hemadri in the case of Kapha Prakopa, Ama Doshas etc Rukshana should be administered before Snehana in the form of Pachana Dravyas.

CONCLUSION

In Rukshana the predominant Guna is Ruksha Guna . Langhana and Rukshana are the Apatarpana Chikitsa. Langhana should be followed where Laghu Guna is desired and Rukshana is adopted where Ruksha Guna is desired. In majority of the cases Pachana itself acts as Rukshana. Rukshana is mainly indicated in Kleda Pradhana Santarpana Janya Vikara with Pitta Kapha Samsrustha Avastha. The best Rasa for attaining Rukshana is Kashaya.

REFERENCES

1. Vagbhatta, Ashtanga Hridaya, Sutrasthana14/1-2.Sarvangasundaran and Ayurveda Rasayan Commentary of Arundatta and Hemadri.Bhisagacharya Hari Sadashiva Shastri ParadakaraVaidhya,editor..Varanasi : Chaukamba Surabharathi Prakashan;2011.p222.

2. Agnivesh, Caraka Samhita, Sutrasthan23/3-7. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011. P122.

3. Agnivesh, Caraka Samhita, Sutrasthan22/10. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Bhavya B.S & Pampanna Gouda H: A Comprehensive Review On The Concepts Of Rukshana

697 www.iamj.in IAMJ: Volume 2; Issue 5; September- October - 2014

Varanasi: Chaukamba Surabharathi Prakashan;2011. P120.

4. Agnivesh, Caraka Samhita, Sutrasthan22/14. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011. P120.

5. Vagbhatta, Ashtanga Hridaya, Sutrasthana16/1.Sarvangasundara and Ayurveda Rasayan Commentary of Arundatta andHemadri.Bhisagacharya Hari Sadashiva Shastri ParadakaraVaidhya,editor..Varanasi : Chaukamba Surabharathi Prakashan;;2011.p243.

6. Chakrapani on Agnivesh, Caraka Samhita, Sutrasthan22/14. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramj Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011. P121.

7. Agnivesh, Caraka Samhita, Sutrasthan22/34-35. Ayurveda Deepika Commentary

byCakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba

Surabharathi Prakashan;2011. P121.

8. Agnivesh, Caraka Samhita, Sutrasthan22/36. Ayurveda Deepika Commentary byCakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011. P121.

9. Agnivesh, Caraka Samhita, Sutrasthan22/41. Ayurveda Deepik Commentary byCakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011. P122.

10. Vagbhatta, Ashtanga Hridaya, Sutrasthana14/2.Sarvangasundara and AyurvedaRasayan Commentary of Arundatta andHemadri.Bhisagacharya Hari Sadashiva Shastri ParadakaraVaidhya,editor..Varanasi : Chaukamba Surabharathi

Prakashan;;2011.p223

11. Agnivesh, Caraka Samhita, Sutrasthan26/53. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011. P146.\

12. Agnivesh, Caraka Samhita, Sutrasthan22/29. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011. P121

13. Agnivesh, Caraka Samhita, Sutrasthan22/30. Ayurveda Deepik Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011. P121

14. Dr K.H,Krishnamurthy , editor P.V Sharma Bhela Samhita with English commentary, Chaukamba Visva Bharathi Varanasi, reprint 2008, Su 21/1 p 92

15. Vagbhatta, Ashtanga Hridaya, Sutrasthana16/37-38 .Sarvangasundara

and Ayurveda Rasayan Commentary of Arundatta and Hemadri.Bhisagacharya Hari Sadashiva Shastri ParadakaraVaidhya,editor..Varanasi : Chaukamba Surabharathi Prakashan;;2011.p251

16. Hemadri - Vagbhatta, Ashtanga Hridaya,Sutrashana14/2.Sarvangasundara and

Ayurveda Rasayan Commentary of Arundatta andHemadri.Bhisagacharya Hari Sadashiva Shastri ParadakaraVaidhya,editor..Varanasi : Chaukamba Surabharathi Prakashan;;2011.p251

17. Agnivesh, Caraka Samhita,

Sutrasthan13/78. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011. P86

18. Agnivesh, Caraka Samhita, Sutrasthan13/53. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor:

Varanasi: Chaukamba Surabharathi Prakashan;2011.P 84

19. Agnivesh, Caraka Samhita, Sutrasthan5/12. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011.P 38

20. Agnivesh, Caraka Samhita, Sutrasthan6/6. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011.P 45

21. Hemadri - Vagbhatta, Ashtanga Hridaya, Sutrasthana1/17.Sarvangasundara and Ayurveda Rasayan Commentary of Arundatta andHemadri.Bhisagacharya Hari Sadashiva Shastri ParadakaraVaidhya,editor..Varanasi : Chaukamba Surabharathi Prakashan;;2011.p12

22. Agnivesh, Caraka Samhita, Chikitsa Sthana 15/198-199. Ayurveda DeepikaCommentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011.P 524

23. Agnivesh, Caraka Samhita, Sutrasthan2/30. Ayurveda DeepikaCommentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011.P 26

24. Agnivesh, Caraka Samhita, Sareera sthana 6/14. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011.P 33

25. Agnivesh, Caraka Samhita, Vimana Sthana 1/24. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011.P 236

26. Agnivesh, Caraka Samhita, Sutra Sthana 26/59. Ayurveda Deepika Commentary by Cakrapanidutta. Yadavji Trikramji Acharya,editor: Varanasi: Chaukamba Surabharathi Prakashan;2011.P 146

CORRESPONDING AUTHOR

Dr Bhavya B S

P G Scholar, Department of Samhita,

SDM College of Ayurveda, Udupi,

Karnataka, India.

Email: drbhavyabams@gmail.com

THE CONCEPT OF BALA, BALA PAREEKSHA AND ITS CLINICAL IMPLICATION

Shahul Hameed et. al: The Concept of Bala, Bala Pareeksha and its Clinical Implication

2 www.iamj.in IAMJ: Volume 1; Issue 5; Sept – Oct 2013

THE CONCEPT OF BALA, BALA PAREEKSHA AND ITS

CLINICAL IMPLICATION

Shahul Hameed Puli Anilkumar Jadhav Lakshmi Prasad Chiplunkar Shivprasad1

Dept. of Kayachikitsa, 1Dept. of Kriya Shareera, SDM Ayurveda College, Hassan, India

ABSTRACT

Bala is considered as the physical and mental strength of the individual. It can be assessed

in healthy individuals as well as diseased. It is helpful in assessing the severity of the disease.

The knowledge of bala of a patient is needed to know about the prognosis and to fix the

dosage, to adopt proper treatment modality and to advice proper regimens for a healthy life style. Information on bala is available in Ayurvedic texts, but at different contexts. Among the explanation given are, bala is one which prevents the roga, one which is adhistana of arogya and

treatment is given for protecting it. Thus examination of bala of an individual is important. It

cannot be assessed solely on basis of parameters alone like body built, as it has explanation in

different contexts like, role of ojus in bala, assessment of prakrutha Kapha as bala, assessment

of shareerika , manasika and vyadhikshamatva bala. There are different methods available for

assessing bala, so in this study an attempt is being made to collect informations available on

concepts of bala and suggest an appropriate method for assessment of bala.

Keywords: Ojus, Vyadhikshamatva, Ardha vyayama shakti, bala

NEED FOR STUDY

There are different concepts on bala and it is of wide use in health and treatment of an individual. There is a necessity to understand the concept of bala pareeksha in patients and healthy individuals. Charaka, Vaghbata and Sushruta have explained about concepts of bala. The present review was done in order to collect the concept of bala, its pareeksha and its implication.

MATERIALS & METHODS

A thorough search was done in Astanga Hrudaya, Charaka smhitha, Sushrutha Samhita and the available commentary on it and the contents and references were analyzed and used for the study.

Various concepts of bala in Ayurveda Ojus as bala

Acharya Sushrutha mentions that the final and excellent essence of dhatus beginning with Rasa to Shukra is Ojus and that Ojus is said to be bala.1 Dalhana has commented on this as Ojus is the cause for predominance of bala to sampurna shareera.2 Vagbhata supports this by mentioning that Ojo vrudhi leads to thushti, pushti and bala.3 Acharya Charaka says that normalcy of Kapha is said to be bala and it is considered to be ojus. Vitiated kapha is mala and it causes disease.4 Sushruta also mentions Prakruta karma of ojus as , stability, growth of muscles, ability to perform all the activities without any hindrance or obstruction, clarity of voice, brightness or complexion.5

Shareerika bala

Charaka explains regarding dasha vidha bala pareeksha, which is a combination of rogi pareeksha and roga pareeksha.

Prakrutyadi nine fold examinations except vikrititah are for athura bala pramana. Vikrititah

pareeksha is for vyadhi bala pramana.6 Sushrutha mentions about sthaulya, karshya and Madhya shareera, among them madhya shareera is considered balavan.

One who consumes food which is not excessive unctuous and dry, digested annarasa circulates all over the body and nourishes all dhatus equally. Due to this the person is said to be madhya  shareera. He is having good ability to perform the physical activities, he can tolerate hunger, thirst, cold, heat, pain, sunlight. He is said to be balavan.7 Charaka explains about sama samhatha purusha, that one whose shareera mamsa and shareera samhanana are even in measurement, whose indriyas are stable, devoid of vikara due to good bala, who can tolerate hunger, thirst, heat, cold, increased body activities, whose jataragni and digestion are good.8 This can be considered as strength attained by proper food intake, the physical abilities and proper sensory perception.

Manasika bala

One among the dasha vidha bala pareeksha is satwa pareeksha which can be considered as mental strength. It is of pravara, madhyama and avara respectively.9

Vyadhikshamatva bala

Charaka explains regarding Vyadhikshamatva as, all shareera will not have similar vyadhikshamatva. This is considered as ones immune power. It varies from person to person. Chakrapani comments that it is the one which protects the body from disease and prevents from reoccurrence of disease. Charaka explains about Vyadhi asaha purusha as, one who is athisthula,

athikrusha, whose mamsa, shonitha and asthi dhatus are not well formed, who is durbala, who consume asatmya ahara, who consume less quantity of ahara and who is alpa satwa, these persons will not have vyadhikshamatha. The persons opposite to these features possess vyadhikshamatha.10

Types of bala: It is of 3 types sahaja, kalaja and yuktikrutaja bala.

Sahaja bala The shareerika and manasika bala which is attained due to matruja and pitruja bhavas like rasa rakta virya ojus is sahaja bala,which can be considered as strength attained from hereditary.

Kalaja bala which is attained from impact of rutus and other which is attained in different vayas. In adana kala the bala of individual will be less and in visarga kala it will be more. The bala will be alpa, uttama and alpa in child, young and old age respectively.

Yuktikrutaja bala Bala which is attained from food and nutrition and physical activities.11

Method of bala pareeksha

Charaka while explaining the pareeksha by anumana pramana mentions that Bala should be assessed by vyayama shakti.12 Vyayama means performing different bodily movement i.e. chesta.13 Through ones vyayama shakti, karma shakti can be assessed and it can be classified under three types i.e. pravara, madhyama and avara bala. If the person can perform more physical work then he is of pravara bala, if moderately then madhyama bala and if less then

avara bala.14

Sushruta explains that bala is one among dwadasha pareeksha. The physician before commencing treatment, should first examine ayu, vyadhi, rutu, agni, vaya, deha, bala, satva, satmya, prakruti, bhesaja, and desha should be examined.15 Vagbata explains that physician should examine ten factors such as dushya, desha, bala, kala, anala, prakruti, vaya, satva, satmya and ahara.16

The bala can be assessed by dasha vidha athura bala pareeksha as follows:

Prakruti – If the person is of Vata prakruti then he is having alpabala, of Pitta prukruti then madhyama bala and of Kapha prakruti then balavan.

Vikruti - Here the roga is assessed through dosha, dushya, kala, bala.

Sara: To know the bala of purusha, ashta saras are explained. If the person is of Rakta

sara then he is having anatibala, if the person is of Mamsa, Majja and Shukra sara then he is balavanta and if the person is of Sarva sara then he is atibala.

Samhanana: The compactness is explained as well demarcated bones, well bound joints and well formed muscles and blood. If a person’s compactness is good then he is balavan, if not, alpabala and if his compactness is moderate then he is of madhyama bala.

Pramaanatah: It’s measured by one’s own anguli pramana. The person with proper measurement of the body are endowed with longevity, strength, immunity, happiness, supremacy, wealth and other desired qualities. The body with less or more measurement has qualities contrary to this.

Satmyatah: If the person is Sarvarasa satmya then he is balavan, if the person is Eka rasa satmya then he is of alpabala and if madhyama then madhyama bala.

Sattwatah: Here satwa means mano bala. It is of three types. The person with pravara satwa possesses pravara dhee, dhruthi and smruti, he will be able to bear stronger therapies, can tolerate severe nija and agantuja roga , adopts same sort of feelings towards happiness or sorrow, will be under control by themselves and predominant of satwa guna. The person with madhyama satwa will be of madhyama dhee, dhruthi and smruti , he will be able to bear stronger therapies,

predominant of rajo guna, tolerates when controlled by others, with much difficulties tolerates severe nija and agantuja roga, he tolerates and adjust to pain or odd situations. Persons with avara satwa will have avara dhee, dhruthi and smriti. They cannot sustain mental stress, in spite of having good physic they are susceptible to fear, grief, greed and delusion. If they hear frightening narratives or on the look of animal or human flesh or blood, get afflicted with anxiety, fainting or even succumb to death. These people are contra indicated for samshodhana therapy, they cannot tolerate pain, and they are predominent in tamoguna.

Ahara shakti: This is examined by the power of ingestion as well as digestion. Strength and life depend on ahara shakti.

Vyayama shakti: If the person can perform more physical work then he is of pravara bala, if moderately then madhyama bala and if less then avara bala.

Vaya shakti : Baala- up to16 yrs are alpa bala, Madhyaavastha- 16 to 60 yrs are uttama bala and

Jeernaavastha- 60 to 100 yrs are alpa bala.17

Balaardha lakshanas:

It is told that bala should be examined through vyayama shakti. But up to what extent one should perform vyayama is not mentioned. So here the reference of samyak vyayama lakshana and bala ardha lakshana or ardha vyayama shakti can be adopted. After appearance of these symptomsmone should stop performing the vyayama. The lakshanas are appearance of sweat over  forehead, axillary region, nose, hands, foot, joints and mukhashosha, increased respiratory rate, lightness of the body, increased heart rate.18, 19

Methods available in modern science at present day are:

Harvard step test: The individual should step up and down off a gym bench for 5 minutes

at a rate 30 steps/minute. The pulse is measured every one minute after finishing the test. Pulse1, pulse 2 and pulse 3 are recorded and it is calculated in this formula.

Result = 30000 ÷ (pulse1 + pulse2 + pulse3)

Handgrip strength test: The individual holds the handgrip dynamometer in the hand, with the arm at right angles and the elbow by the side of the body. Squeeze the dynamometer with maximum isometric effort, which is maintained for about 5 seconds. Result is recorded in kilograms.

Push up Test: To do this, the individual should kneel on the floor, hands on either side of the chest and keep the back straight. Do as many pushups as possible until exhaustion. The total number of pushups performed is counted.

Bruce Protocol Stress Test: The individual is made to run on a tread mill. At three minute intervals the incline of the treadmill increases by 2% and the speed increases. The test score is the time taken on the test, in minutes.20

Clinical implication

For balavan rogi the treatment given yields better result and the prognosis is good. If rogi is durbala, the treatment may not yield better results and the prognosis may be bad.

To understand the prognosis of disease like in rajayakshma if patient’s bala and mamsa is kshina then the disease will turn into asaadhya and if the bala and mamsa is akshina, the disease is saadhya.To decide the nature and potency of the drug, assessing the bala is helpful.

Administration of thikshna veerya aushadhito a durbala person leads to shareera hani and heena veerya aushadhi to a sabala person leads to reduced action of drug.

The dosage of drug can be fixed on pravara, madhyama and avara bala respectively to avoid upadrava.

If samshodhana aushadhis administered to a dhurbala rogi, it may lead to athi dosha kshaya which intern leads to athi dhurbula. So assess the bala of patient before shodhana.

As mano and shareerika bala are uttama in guruvyadhita, physician may get confused as laghu vyadhita. Similarly, mano and shareerika bala are heena in laghu vyadhita, physician may get confused as guru vyadhita.

DISCUSSION

As bala is assessed by vyayamashakti, it can be considered as shareerika bala. Satwa is considered as manasika bala. The concept of ojus and its karma can be considered as vyadhikshamatva bala. So bala can be assessed in three ways i.e. physically, mentally and immunologically. For assessing the manasika bala, pravara, madhyama and avara satwa qualities are assessed. For assessing vyadhikshamatva bala, the lakshanas of vyadhi asaha purusha, sahaja bala, kalaja bala, yuktikrutaja bala and ojo bala should be evaluated.

For assessing the shareerika bala, different vyayama such as tulabramana, gunakarshana,

dhanurakarshana are explained in the texts. Similarly in modern aspect, different methods such as Harward step test, Bruce protocol stress test, Push up test, Hand grip test are explained. These methods can be adapted to assess the physical strength.

CONCLUSION

Bala pariksha is an important factor for ascertaining rogi bala, prognosis and proper treatment. It is an important factor for assessing the fitness levels of apparently healthy persons. It can be improved by adopting proper ahara and vihara. Physician should give importance to bala pareeksha before commencing the treatment. Different tests in modern science can be used to assess the physical strength.

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CORRESPONDING AUTHOR

Dr. Shahul Hameed

PG Scholar of Kayachikitsa

SDM College of Ayurveda & Hospital, Hassan,

Karnataka, India

Email: anilpuli16@gmail.com

Source of support: Nil

Conflict of interest: None Declared